Thursday, 25 July 2013

A Royal Delivery

Lavender's blue, dilly dilly, lavender's green,
When I am king, dilly, dilly, you shall be queen.
A man drives away from a central London hospital in a black car. His wife and new-born son sit in the back. They're on their way to a new life, the first few days as a new family. Doctors, nurses, midwives, journalists and families wave them on their way. A new life! A new mother! What could be more wonderful? A precious new family delivered safely.
It is breath-taking to consider how much has changed for women in the two centuries since Queen Victoria’s perilous, chloroform-hazed delivery. 
Princess Kate had a natural hypnobirth in a dedicated hospital surrounded by a plethora of healthcare professionals. But the NHS too, provides a choice about how and where to give birth. Mothers are no longer at the mercy of our class and financial means. Hospitals provide home-from-home rooms or midwife-led birth centres alongside acute obstetric care. We have access to birth pools, stools, aromatherapy, massage, candles, soft lighting, music, properly trained midwives, nurses, obstetricians, paediatricians and neonatologists. If things go awry we have ventouse, forceps, epidural and caesarean section. 
Women can expect to hold their new born baby in their arms at home or in hospital with nothing more challenging than "what shall we call our little Prince...?" and "how does this nappy work...?" on our minds. 
It is no longer common place to die in childbirth or in the weeks after due to infection and blood loss. Thousands of us no longer perish in dirty hospitals or in fear that a doctor won't arrive in time or that the local midwife has no proper training. Our children do not have the tragic memory of a narrator in Spirit of 45, who was told after the birth of his new brother in the 30s that “your mam died but for the want of a pint of blood”.
But a new era is dawning. Across the country, maternity services are being downgraded and cut. NHS England doesn't like to admit it. Their propaganda is full of vacuous words about 'providing a safe service for women' and offering 'real choice'. But under their plans, choice and safety will be reduced, and more women will have to travel further to larger hospitals in order to give birth.
Lewisham Hospital is just one of many scheduled for downgrade by Professor Sir Bruce Keogh's trigger happy bombardment of our maternity services. This small district general hospital in South London supports over 4,500 deliveries a year. Lewisham offers a range of services to women: home birth, a prestigious birth centre and a highly successful acute obstetric labour ward. 
Should the downgrade take place, women will be 'dispersed' across several neighbouring hospitals. This will mean that thousands of women will face a travel time of over an hour in busy London traffic. Can you imagine getting a bus - sometimes two or even three - while in the throes of labour? Most residents of Lewisham don't own a car and taxis will not transport women in labour. 
St Thomas', King's and Queen Elizabeth hospitals will have to double their obstetric provision in order to meet demand. They're already running over full capacity. For women this will mean a conveyor belt care package, no continuity of care and potentially lethal transfer times in the back of ambulances.
NHS England, backed by the Secretary of State for Health, has spent an enormous amount of money to justify their claim that the priority for hospital care is 24 hour consultant cover, more centralisation and fewer hospitals. That strokes and heart-attacks can be better served by fewer, more specialist hospitals. 
But even if that is the case for those conditions, maternity isn't a disease. It isn't something that should be 'treated'. It requires a wholly different approach to other health specialities.
Private consultants like Mckinseys and Deloitte enrich themselves with their public sector work, including running sham consultations. But - as I found myself - they don't seem to find the time to actually ask women what they want or what they need. They can barely be bothered to listen to health professionals, academics or public health officials about what careful practise and research shows to be fact.
Women want and deserve to be cared for as individuals, with access to the service they personally require. Women want a named midwife. They want a safe, quiet, small environment in which to give birth. Not an over-sized, over-stretched anonymous hospital with a hive of faceless midwives and doctors.
The days in which all women could expect the same level of safety, care and choice as the richest and most celebrated women in the land will soon be over. In some parts of the country they are already long gone
And this is wrong. It's wrong for women, it's wrong for babies, it's wrong for public health and it will inevitably turn the clock back on the huge progress we have made over the last couple of centuries.
Lavender's green, dilly, dilly, Lavender's blue,
If you love me, dilly, dilly, I will love you.
Let the birds sing, dilly, dilly, And the lambs play;
We shall be safe, dilly, dilly, out of harm's way.

Tuesday, 2 July 2013

The Regime for Unsustainable Providers could be coming to a hospital near you!

I ask you, can one small district general hospital save the NHS?

The Save Lewisham Hospital campaign are hoping so and this week is going to be a crucial one for us south east Londoners. That's right folks, we've taken our fight to the High Court.

A year ago South London Healthcare Trust was put into administration by Jeremy Hunt. A Trust Special Administrator was put in post and tasked with a seemingly impossible job: sort out the ailing finances of a Trust burdened with a monstrous PFI contract.

It's a fact universally acknowledged for those in south London that SLHT has been doomed for years, there have been several unsuccessful plans to rescue it, so no one was particularly surprised when the government put it into administration. The shock came a few months later, in October, when Trust Special Administrator, Matthew Kershaw, announced that the debts of SLHT were too gigantic and complex to be solved within the bounds of the Trust alone and that he would look at neighbouring Trusts to help shoulder the burden. Suddenly the coffers of Lewisham Hospital looked quite appealing. 

Matthew Kershaw clearly thought it wasn't impossible to appropriate some of Lewisham's capital and real estate in his attempt to balance the books. Never mind that the piece of legislation he was using at the time (The Regime for Unsustainable Providers) specifically states that it cannot be used outside the Trust or for service reorganisation.

I shan't go on about the highs and lows of the campaign first to challenge the bizarre misuse of The Regime for Unsustainable Providers and then to exhort Jeremy Hunt MP to recognise the illegality of Kershaw harvesting the vital organs of Lewisham Hospital’s actute services and obstetric-led maternity care.

As you know from our previous forays into the wonderful world of publicity, we like a bit of style in Lewisham. Boris Johnson won't forget his red carpet treatment in February and I am sure I saw the curtains twitch at the Department of Health when Lewisham's Buggy Army descended en masse for a true Valentine's celebration.

So, can you blame us for attempting to make history once again?

This time we've brought in the big guns. Michael Mansfield QC and his special force of barristers from Tooks Chambers joined us for a trail-blazing run at the iniquities of this government's onslaught on the NHS. Allyson Pollock, Colin Leys and Lord Owen all spoke in defence of our precious local hospital and to paint the greater picture of the need to save the NHS from marketisation and privatisation.

Over the course of one day we heard from 25 witnesses giving evidence in a People's Commission chaired by Michael Mansfield and supported by Baroness Warnock and Blake Morrison as fellow judges. The evidence was given by doctors, nurses, patients, carers, the CEO of Lewisham Hospital and yours truly in my role as Chair of Lewisham Maternity Service Liaison Committee. In one voice we argued the case against the Trust Special Administrator and against the destruction of the NHS. It was an amazing example of People Power. I am proud to have been part of it.

Today two judicial reviews started their hearings at the High Court. By Friday we'll know the fate of our hospital.

If Lewisham Hospital is downgraded no hospital in the United Kingdom will be safe so be on your guard; watch out! The Regime for Unsustainable Providers could be coming to a hospital near you so support our campaign at the High Court before it's too late.

I'll leave you with the words of Aneurin Bevan's leaflet to launch the NHS 65 years ago
Your new National Health Service starts on the 5th July. What is it? How do you get it?
It will provide you with all medical, dental, and nursing care. Everyone – rich or poor, man, woman or child – can use it or any part of it. There are no charges, except a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in times of illness. (National Health Service Leaflet 1948)